Hypertension, Habitual Snoring, and Adverse Pregnancy Outcomes

Pregnant women with hypertension are at high risk for obstructive sleep apnea, a condition that often goes undiagnosed.

In a small study, researchers at the University of Michigan found that a quarter of all hypertensive pregnant women who don’t snore and that half of all hypertensive pregnant women who do snore are at risk for the sleep disorder.¹

Pertinent Points

- Obstructive sleep apnea was diagnosed in half of all hypertensive pregnant women who snore, a small study found.

- A quarter of pregnant women with hypertension who don’t snore were also found to have sleep apnea, although their cases tended to be milder than those who did snore.

There is an urgent need to more deeply explore the findings, the authors said, also stating that longitudinal and interventional studies must be conducted. Because the association was so pronounced, the authors urged all pregnant women who snore to be tested for obstructive sleep apnea. In addition, they noted that obstructive sleep apnea is a condition that is believed to cause or promote hypertension.

"We know that habitual snoring is linked with poor pregnancy outcomes for both mother and child, including increased risk of C-sections and smaller babies," said lead author Louise O'Brien, PhD, MS, associate professor at the university’s Sleep Disorders Center in the Department of Neurology and adjunct associate professor in the Department of Obstetrics & Gynecology. "Our findings show that a substantial proportion of hypertensive pregnant women have obstructive sleep apnea and that habitual snoring may be one of the most telling signs to identify this risk early in order to improve health outcomes."

The authors diagnosed obstructive sleep apnea in 31 (61%) of 51 women with hypertensive disorders. Conversely, obstructive sleep apnea was diagnosed in only 3 of 16 women with normal blood pressure.

Non-snoring women with hypertensive disorders typically had a milder case of the disorder compared with women who snored.

Citing his previous research showing associations between snoring during pregnancy and higher risk for C-sections and smaller birth weights, O’Brien said prompt management of the sleep disorder could improve the health of both mother and child.^2,3

References:

1. O’Brien LM, Bullough AS, Chames MC, et al. Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study. BJOG. May 29, 2014. DOI: 10.1111/1471-0528.12885. Abstract available at: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12885/abstract.

2. O’Brien LM, Bullough AS, Owusu J, et al. Snoring during pregnancy and delivery outcomes: a cohort study. Sleep. 2013;36:1625-1632. Abstract available at: http://www.journalsleep.org/ViewAbstract.aspx?pid=29169.

3. O’Brien LM, Bullough AS, Owusu JT, et al. Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study. Am J Obstet Gynecol. 2012;207:487.e1-487.e9. Abstract available at: http://www.ajog.org/article/S0002-9378(12)00914-3/abstract.